Validation of diffuse correlation spectroscopy measures of critical closing pressure against transcranial Doppler ultrasound in stroke patients.
Validation of diffuse correlation spectroscopy measures of critical closing pressure against transcranial Doppler ultrasound in stroke patients.
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在脑卒中患者中针对经颅多普勒超声验证临界闭合压的漫射相关光谱测量
DOI：
10.1117/1.jbo.26.3.036008
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发表时间：
2021-03
影响因子：
3.5
通讯作者：
Franceschini MA
中科院分区：
文献类型：
--
作者：
Wu KC;Sunwoo J;Sheriff F;Farzam P;Farzam PY;Orihuela-Espina F;LaRose SL;Monk AD;Aziz-Sultan MA;Patel N;Vaitkevicius H;Franceschini MA
意义：颅内压（ICP）、灌注的变化以及由此产生的缺血是神经重症监护病房患者继发性脑损伤的主要原因。对脑血流（CBF）和颅内压进行持续、准确的监测可指导干预措施，并最终降低发病率和死亡率。目前，只有侵入性工具用于监测颅内高压高危患者。
目的：扩散相关光谱法（DCS）是一种非侵入性近红外光学技术，正在成为一种可能用于持续监测脑血流和临界关闭压（CrCP或零流量压，一个与颅内压直接相关的参数）的方法。
方法：我们优化了DCS硬件和算法以用于CrCP的定量。为了使其向临床转化，我们针对同时获取的经颅多普勒超声（TCD）脑血流速度（CBFV）和CrCP，验证了DCS对缺血性脑卒中患者的脑血流指数（）和CrCP的评估。
结果：我们发现由DCS和TCD得出的CrCP具有高度线性相关性（同侧，；对侧，）。我们发现 与CBFV之间的相关性较弱（同侧，；对侧，），这可能是由于所测量的血管系统不同。
结论：我们的结果表明，DCS是TCD用于持续监测CrCP的一种有效替代方法。
Significance: Intracranial pressure (ICP), variability in perfusion, and resulting ischemia are leading causes of secondary brain injury in patients treated in the neurointensive care unit. Continuous, accurate monitoring of cerebral blood flow (CBF) and ICP guide intervention and ultimately reduce morbidity and mortality. Currently, only invasive tools are used to monitor patients at high risk for intracranial hypertension. Aim: Diffuse correlation spectroscopy (DCS), a noninvasive near-infrared optical technique, is emerging as a possible method for continuous monitoring of CBF and critical closing pressure (CrCP or zero-flow pressure), a parameter directly related to ICP. Approach: We optimized DCS hardware and algorithms for the quantification of CrCP. Toward its clinical translation, we validated the DCS estimates of cerebral blood flow index () and CrCP in ischemic stroke patients with respect to simultaneously acquired transcranial Doppler ultrasound (TCD) cerebral blood flow velocity (CBFV) and CrCP. Results: We found CrCP derived from DCS and TCD were highly linearly correlated (ipsilateral , ; contralateral , ). We found weaker correlations between and CBFV (ipsilateral , ; contralateral , ) probably due to the different vasculature measured. Conclusion: Our results suggest DCS is a valid alternative to TCD for continuous monitoring of CrCP.